| Objective:In this study , we quantitative determined the RV diastolic and systolic function of patients with Hypertrophic Obstructive Cardiomyopathy, Hypertrophic Nonobstructive Cardiomyopathy and normal subjects by non-invasive pulsed wave Doppler Techniques. And then Tei index was calculated. To evaluate RV function and the change of pathophysiology of patients with HOCM and HNCM by the technique of hemodynamics. Data and MethodPatients Selection:28 patients with HOCM and 34 patients with HNCM were selected and diagnosed by strict clinical and assisted examination. The control group: 30 normal subjects who have normal thickness of interventricular septum and left ventricular posterior wall were randomly selected. parenchymal disease were removed in all the normal subjects by demanding history, physical examination, ECG, radiography, echocardiogram and chemicoibital examination. There were no statistically significant differences in the constituent ratio of age and sex among the three group.Equipment and Instrument:Color Doppler ultrasound diagnostic apparatus of HP-sonos 2500 and PHILIPS-sonos 7500 were usd.Observed target:1.Echocardiogram⑴. Pulsed wave Doppler of transtricuspid flow: ①forward interphase of transtricuspid( ms, named a ); ②the interval between the peak of R wave of ECG and just the open of tricuspid( ms, named c )⑵. Pulsed wave Doppler of transpulmonic valve folw: ①right ventricular ejection time( RVET, ms, named b ); ②accelerating time of transpulmonic valve folw/ right ventricular ejection time( ACT/RVET ); ③isovolumetric relaxation time of rtght ventricle( IRT, ms ); ④isovolumetric contraction time of rtght ventricle( ICT, ms ); ⑤the interval between the peak of R wave of ECG and just the closure of pulmonic valve ( ms, named d )⑶. Index needing been calculated: ①IRT: c-d; ②ICT: ( a-b )-( c-d ); ③Tei index: ( a-b )/b=( IRT+ICT )/RVET.Statistics:Continuous numerous variables are expressed as mean value ± SD. SPSS 10.0 statistics software are adopted. Differences in variables of HOCM, HNCM and normal subjects were assessed by one-way ANOVA. A value of P<0.05 was considered statistically significant.Results1 ⑴ACT/ET, ICT, IRT, ICT+IRT, RVET, ACT/RVET and Tei index ( [ ICT + IRT ]/RVET ) tended to be no marked changes between the group of HOCM and the group of HNCM. ⑵The Tei index was distinctly different between patients with HCM ( including the group of HOCM and HNCM ) and normal subjects.(Tei index of HOCM is 0.88±0.39; Tei index of HNCM is 0.73±0.29 ; Tei index of normal subjects is 0.41±0.10; PHOCM<0.001, PHNCM<0.001 ). In comparison with control subjects, the ICT in HCM group were significantly prolonged( PHOCM=0.001, PHNCM=0.03 ). so were the IRT ( P<0.001 ). And right ventricular ejection time( RVET ) was significantly shortened.( PHOCM<0.001, PHNCM=0.005 ). There were differences in ACT/RVET between control subjects and HCM group( PHOCM=0.006, PHNCM=0.02 ). 2. Tei index showed significant positive correlation with ICT,IRT,( IRT+ICT ) and ICT/RVET( r=0.865, 0.516, 0.956, 0.697, respectively) (P<0.001), negative correlation with RVET( r=-0.757, P<0.001 ).Conclusions1 For the patients of HCM, Tei index is valuable and easy for estimating right ventricular systolic and diastolic functions with high sensitivity.2 It is concluded that the decreased right ventricular diastolic and systolic function was founded in patients with HCM( HOCM or HNCM ).3 There were no significant differences in right ventricular function between HOCM and HNCM.
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